Transnasal transsphenoidal resection outcomes in 212 patients with non-functioning pituitary macroadenomas show variable progression rates

This retrospective cohort study included 212 patients with histologically confirmed non-functioning pituitary macroadenomas at a tertiary referral center. The intervention involved transnasal transsphenoidal resection. Patients were assessed for tumor progression in postoperative residual findings over a mean follow-up of 39 months. The study design is observational, meaning associations are reported rather than causal relationships established. The comparator focused on stable residuals versus progressive residuals among the cohort.

Initial radiological gross total resection was achieved in 94/212 (44.3%) of the cohort. Durable complete resection without recurrence occurred in 62/212 (29.2%). Among patients with residual findings, 76 (64.4%) had stable tumors while 42 (35.6%) experienced progression. Recurrence after initial gross total resection was noted in 32/212 (15.1%). Tumor progression correlated with preoperative volume, showing a median of 11.6 cm3 vs 5.81 cm3 for those with larger volumes. These statistics highlight the variability in long-term outcomes following surgical intervention for this specific pathology.

Safety data regarding adverse events, serious adverse events, and discontinuations were not reported in the abstract. Limitations were not reported, though the single-center setting may affect generalizability. Practice relevance supports individualized decisions regarding follow-up and adjuvant therapy. Clinicians should note the retrospective nature when applying these findings to patient care. The lack of safety reporting requires careful consideration when weighing risks against benefits in clinical practice settings. Additional context on long-term outcomes remains limited.